Can Americans Trust RFK Jr.'s Health Advice? A Breakdown on Vaccines, Autism, Food Dyes, and More
As ever, be cautious about what you hear from the Department of Health and Human Services.
Can the public trust health recommendations from the Department of Health and Human Services (HHS)? Be cautious.
HHS and its associated agencies have an imperfect record when it comes to promoting the health of Americans. For example, HHS' food pyramid recommended substituting carbohydrates for fats, which ultimately contributed to increased rates of obesity. Under President Joe Biden, HHS began to impose price controls on pharmaceuticals, which will harm patients by slowing biomedical innovation. The National Institutes of Health financed viral gain-of-function research in China that may have resulted in unleashing the COVID-19 pandemic. HHS' six-foot social distancing rule during the pandemic was not underpinned by any research.
Now, under Secretary Robert F. Kennedy Jr.'s leadership, there is even more reason to be particularly wary about pronouncements emanating from the agency.
It was well known coming into the Trump administration that Kennedy founded one of the nation's leading anti-vaccine activist groups. As secretary of health and human services, he sacked the 17 vaccine experts on the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) and seeded the committee with anti-vax advocates. In June, the panel voted to remove the preservative thimerosal from flu vaccines though there was no scientific evidence of harm.
In September, the new ACIP panelists voted for a standalone chickenpox vaccination, citing a low risk of febrile seizure from a vaccine that combined chickenpox protection with protection against measles, mumps, and rubella. The American Academy of Pediatrics decried this limit on parental choice, though it is worth noting that 85 percent of parents already opt for separate vaccines.
In the meantime, Kennedy's watch saw the U.S. experience its largest outbreak of measles in the past 33 years.
Recall that Kennedy infamously asserted back in December 2021 that the COVID-19 vaccine "is the deadliest vaccine ever made." Reams of subsequent research have found that COVID-19 vaccines are in fact generally safe and effective. Nevertheless, Kennedy has sought to limit universal access to annual booster shots. In August, the Food and Drug Administration (FDA) limited boosters to adults over 65 years old and those with underlying conditions that increase their risk for severe disease. In a June editorial in the New England Journal of Medicine, FDA officials previewed the new August limitations and said they are broadly in line with booster recommendations in Europe, Australia, and Canada. In contrast, the ACIP in September essentially enabled all Americans over 6 months old to access COVID-19 boosters by unanimously recommending that vaccination be determined by individual decision-making.
In June, Kennedy falsely stated that the Centers for Disease Control had suppressed a hepatitis B vaccine study in newborns in 1999 that found "an 1,135 percent elevated risk of autism among the vaccinated children." In fact, the researchers cited by Kennedy reported in 2003 that they found "no consistent significant associations" between the vaccine and autism. Infants infected with hepatitis B via mother-to-child at birth or during their first year of life have a 90 percent chance of developing a chronic infection—of which 15 to 25 percent will eventually die of cirrhosis or liver cancer. Since vaccination for all newborns was approved in 1991, infections with the hepatitis B virus in children and teens have decreased by 99 percent.
Fortunately, even Kennedy's handpicked ACIP panel could not bring itself in September to vote against providing newborns with the hepatitis B vaccine. President Donald Trump, on the other hand, was not so reticent, asserting that since hepatitis B is "sexually transmitted," vaccination should "wait till the baby is 12 years old."
Kennedy has notoriously been a vocal proponent of the discredited claim that vaccines cause autism. In April, Kennedy promised that by "September, we will know what has caused the autism epidemic and we'll be able to eliminate those exposures." Surprisingly, he zeroed in not on vaccines but on acetaminophen, the chief ingredient in the painkiller Tylenol. Trump claimed that taking acetaminophen "can be associated with a very increased risk of autism." He advised pregnant women experiencing pain or fever to "tough it out a little bit" and to "fight like hell not to take it."
A recent meta-analysis of 46 studies mentioned at the press conference suggested a possible link between prenatal use of acetaminophen and autism. (One of the authors of the study was paid $150,000 as an expert plaintiffs' witness in lawsuits against the maker of Tylenol.) At the press conference announcing the alleged acetaminophen connection, FDA chief Marty Makary acknowledged: "Sure, you'll be able to find a study to the contrary."
Actually, a lot of studies.
For example, another meta-analysis evaluating 56 studies published last year concluded that taking acetaminophen during pregnancy is "unlikely to confer a clinically important increased risk of childhood [attention-deficit hyperactivity disorder] or [autism spectrum disorder]." Last year, a Swedish study found "no evidence" of increased autism risk in children whose mother used acetaminophen during pregnancy.
Makary's subsequent notice to physicians about acetaminophen did not urge pregnant women to "fight like hell not to take it." Makary's notice more circumspectly observed that "a causal relationship has not been established and there are contrary studies in the scientific literature." He added that "acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics; aspirin and ibuprofen have well-documented adverse impacts on the fetus."
At the press conference, Kennedy touted leucovorin as a treatment for autism. Leucovorin, a medication similar to the B vitamin folic acid, is generally used to counteract the effects of cancer chemotherapy. Some small preliminary studies suggest that it can be helpful in treating autistic patients with cerebral folate deficiency. Depending how it's measured, between 7 percent and 30 percent of autistic patients experience low levels of folate. The FDA is working to make it available to such patients. The Coalition of Autism Scientists, however, cautioned that "it is premature to claim that leucovorin is an effective treatment for autism." Since the side effects of the drug taken alone are rare and generally mild, there appears to be little downside to trying it.
Despite the focus on Tylenol, Trump could not refrain from suggesting that "pumping" vaccines into "a little fragile child" is linked to autism. Kennedy supported Trump, claiming that for three decades "research on the potential link between autism and vaccines has been actively suppressed." He vowed that this department "will take the time for an honest look at this topic by scientists." As part of "an honest look," the Department of Health and Human Services has hired David Geier, a long-time proponent of the claim that vaccines cause autism, to oversee a new study probing the possible links between vaccinations and autism.
In April, Kennedy declared that "sugar is poison." Varying estimates of average added sugar consumption converge to around 17 teaspoons daily, which amounts to about 64 pounds annually per American. Accumulating evidence suggests that the secretary has a point; consumption of added sugar contributes to increased obesity rates, Type 2 diabetes risk, and fatty liver disease. Kennedy has commended Coca-Cola and Tyson Foods for replacing high fructose corn syrup with cane sugar. One problem: There is essentially no nutritional difference between them. That said, health-conscious Americans would do well to heed Kennedy's call to consume less sugar.
As for food dyes, as recently as 2023 the FDA concluded that the totality of the evidence showed no adverse effects when children consume foods containing color additives. That was then, but this is now. In April, Kennedy denounced synthetic food dyes as "poisonous compounds." At the time, he laid out a timeline for the food industry to transition to natural alternatives by 2027.
He also turned his eye toward fluoride. Since 1945, many American towns and cities have added minute amounts of fluoride to their drinking water as a way to significantly prevent tooth decay. Back in November, Kennedy described fluoride as "industrial waste" and pledged to have it removed from public water supplies once in office. In April, Environmental Protection Agency chief Lee Zeldin promised without prejudging outcomes to expeditiously review drinking water fluoridation science. In fact, a recent meta-analysis found that drinking water containing more than 1.5 milligrams per liter of fluoride slightly lowers children's I.Q. scores. Keep in mind, though, that the recommended level of fluoridation in the U.S. is 0.7 milligrams per liter. A 2023 meta-analysis found that the level of fluoride in community water systems "is not associated with lower IQ scores."
The Department of Health and Human Services is a sprawling bureaucracy that encompasses the Centers for Disease Control, the FDA, the National Institutes of Health, and the Centers for Medicare & Medicaid, among other offices. The agency spends about $2 billion per day. The federal government was responsible for $1.9 trillion of the $4.9 trillion spent on health care in 2023, and FDA-regulated products account for about 21 cents of every dollar spent by U.S. consumers. As the scope of Kennedy's initiatives show, his agency's vast powers allow him to inflict his peculiar obsessions on the health and lives of Americans—for good and for ill.
